Abstract:

BACKGROUND: In recent years, monitoring of cyclosporine A peak plasma concentration (C2) can be more accurately reflect pharmacokinetical changes of cyclosporine A in vivo, which is more reasonable to guide clinical medication than detection valley concentration (C0). However, the statistics addressing large sample clinical data are few. 
OBJECTIVE: To explore the clinical significance of monitoring C2 and C0 levels to determine the anti-rejection drug efficacy and side effect of cyclosporine for early postoperative of renal transplant patients.
METHODS: TDX was used to synchronization monitoring C0 and C2. Totally 78 cases of kidney transplantation were retrospective analyzed. According 6-month observation, 48 cases with out complications served as normal group, 16 cases with acute rejection served as acute rejection group, and 14 cases appeared intoxication served as intoxication group. The changes of C0 and C2 during acute rejection and drug toxicity were observed.  
RESULTS AND CONCLUSION: There was no significant difference in C0 level prior to and after acute rejection (P > 0.05), both of which were lower than that of the normal group (P < 0.05). At 1 month after transplantation, C0 and C2 levels of intoxication group were obviously greater than that of the normal group (P < 0.05). At 2-6 months after transplantation, there was no significance between the intoxication group and the normal group in C0 (P > 0.05), but C2 was obviously increased in the intoxication group (P< 0.05). The findings demonstrated that monitoring C2 can effective predict the occurrence of acute rejection after kidney transplantation; C2 detection at 2-6 months after transplantation can predict the occurrence of liver damage and nephropathy.